Author + information
- Yashwant Agrawal,
- Chris Jacob,
- Carleigh Zahn,
- Sourabh Aggarwal,
- Sidakpal Panaich,
- Frank Saltiel,
- Jagadeesh Kalavakunta and
- Vishal Gupta
Background: Acute myocardial infarction (AMI) is associated with traditional risk factors of diabetes, hypertension, hyperlipidemia and smoking. However, impact of hereditary causes of thrombosis (HT) on AMI is largely unknown. HT includes primary hypercoagulable state, activated protein C resistance, antithrombin III deficiency, factor V Leiden mutation, lupus anticoagulant, protein C deficiency, protein S deficiency and prothrombin gene mutation. This study was designed to study the influence on HT on AMI in the US from 2008-2012.
Methods: We used Nationwide Inpatient Sample (NIS) to extract data for patients hospitalized with primary diagnosis of AMI corresponding to ICD 9 codes of 410.xx. HT was identified with ICD 9 code 289.91. NIS represents 20% of all hospital data in US. Data was extracted for the years 2008-2012. Logistic regression models were used to analyze the association between HT and AMI.
Results: A total of 4,690,802 weighted discharges were identified with primary/secondary diagnosis of AMI of which 14,579 also had HT. Mean age of AMI patients with and without HT was 60.6 and 69.3 years, respectively. More males had AMI and HT when compared to females (52.4% vs. 47.6%). Likewise, for AMI patients without HT, males were predominant (57.3% vs. 42.7%). When controlling for demographics, diabetes and hypertension; estimated odds for a length of stay more than 1 week for AMI was 2.52 (95% CI: 2.31, 2.74; p<0.0001) times greater in patients with HT. Similarly, estimated odds for total charges for AMI was 1.34 (95% CI: 1.28, 1.40; p<0.0001) times greater in patients with HT. Estimated odds for in-hospital mortality for AMI with HT was 1.47 (1.30, 1.68; p<0.0001) times greater than for AMI without HT.
Conclusions: This study attempted to characterize the impact of HT on AMI. Our study is perhaps the first showing a statistically significant increased length of stay, hospital charges and in-hospital mortality in patients admitted for AMI with underlying HT compared to patients without HT. Interventions need to be directed to prevent increased economic burden and in-hospital mortality for this subset of patients. Continued studies are needed to investigate the influence of HT on AMI.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-323
- 2017 American College of Cardiology Foundation